Review Reveals Gaps in Medicare Antifraud System
A recent Associated Press review found that despite efforts to curb fraud, federal regulators often suspend Medicare provider licenses only to quickly reinstate them after appeals hearings. The review found that from 2006 to 2009, officials revoked the Medicare licenses of 3,702 medical equipment companies in California and five other states and that about 37% of those providers got their licenses back. Many of those suppliers regained their licenses because neither the government nor the private contractors attended the initial appeals hearing, allowing the providers to win by default. The AP also found that CMS has failed to collect from surety bonds, a practice the agency instated in 2009 to ensure it could recoup money if a provider was committing fraud.
- "AP: Medicare Yanks Licenses, Gives Them Right Back" (Kennedy, AP/Houston Chronicle, 10/16).